Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Improved procurement could more than double availability of life-saving transplant organs

25.09.2003


Yet study finds that even with greater efficiency, supply of organs will not meet transplant demand



Last year, fewer than 6,200 people in the United States donated organs though more than 80,000 waited for organ transplantations. Each day, an average of 17 people die while waiting for a transplant.

Even though the need for transplantable organs far outweighs the supply, the number of organs donated could be more than doubled--saving thousands of lives every year--if the procurement process were improved. These findings by researchers from Harvard Medical School, Boston University, and the Institute for Healthcare Improvement appear in the summer issue of Health Care Financing Review published this week.


Although millions of people across the country are registered donors, only two percent of them annually suffer brain death and meet the other medical requirements for being a cadaveric donor. The U.S. Department of Health and Human Services (HHS) suggests that the number of actual donors may be further limited by organ procurement organizations (OPOs) that do not utilize the most efficient practices.

"We needed to know if we have a supply of potential donors who can meet the demand for organs," said Edward Guadagnoli, first author on the study and an associate professor of health care policy at Harvard Medical School. "We didn’t know until we used a statistical model to estimate that number." The researchers determined that the number is about 17,000 potential donors each year.

OPOs coordinate the organ donation process and match potential donors to recipients. They also deal directly with the potential donor’s family to get consent for donation. Organ donation usually comes at a difficult time for families, and the way an OPO addresses the situation can mean the difference between saving a life through transplantation and losing a potential donor. Family resistance to organ donation is the primary reason that potential donors do not donate.

According to the study, OPOs have an efficiency rate of between 20 and 80 percent, with an average rate of about 34 percent. In other words, the country’s medical industry is using only one third of the potential donors.

Even with 100 percent OPO efficiency, Guadagnoli says, there still would not be enough potential donors to supply the current demand for organs.

"There are simply not enough. We figure there are about 17,000 potential donors a year, but the current need is too great. Every year, the number of people waiting increases," Guadagnoli says.

On September 9 and 10, HHS led the first of three seminars focused on increasing the number of actual donors. HHS Secretary Tommy Thompson is calling for OPOs to increase their efficiency to 75 percent, a goal that Guadagnoli says is high, but may be possible.

Other organ sources include living donors and xenotransplantation--the transplantation of an animal organ into a human. Yet cadaveric donations still provide almost 75 percent of transplanted organs. Guadagnoli says there is nothing on the medical horizon that can replace or significantly supplement this organ source.

Principal InvestigatorBiosketch

Edward Guadagnoli, Ph.D.
Associate Professor of Health Care Policy
Department of Health Care Policy
Harvard Medical School.

Edward Guadagnoli, Ph.D. is an Associate Professor of Health Care Policy in the Department of Health Care Policy at Harvard Medical School. He is also an Assistant Epidemiologist in the Department of Medicine at Brigham and Women’s Hospital.

Dr. Guadagnoli’s research focuses on evaluating the quality and outcomes of health care, examining access to health care, and evaluating health care interventions. His work in the area of cancer care has touched on all of these topics. He has studied the quality of and access to cancer care in various regions of the United States and he has led an evaluation of an intervention to improve discussion of treatment options between patients and their surgeons. He is currently leading a study to examine how well publicly available data such as Medicare billing data and hospital discharge data can characterize the quality of care provided to women with breast cancer. As part of another project, he is studying the factors associated with prescription of and compliance with tamoxifen therapy in patients diagnosed with early-stage breast cancer. He is also a member of the Cancer Care Outcomes Research & Surveillance (CanCORS) Consortium, which is studying the quality of care provided to patients with lung or colorectal cancer treated across the United States.

Since arriving at Harvard, Dr Guadagnoli has been involved in several large-scale projects to study the quality of care for patients with cardiovascular disease. His work in this area focuses on understanding the factors related to variation in practice across geographic areas and on determining how variation in practice is associated with the quality of care provided to patients. He recently completed an evaluation of the quality of cardiac care services provided by the Veterans Health Administration. He is also involved in a project to develop quality indicators for the care of patients with acute myocardial infarction, congestive heart failure, or hypertension.

As part of his work in the areas of quality of care assessment and evaluation of health care interventions, Dr. Guadagnoli is leading an evaluation of the Health Disparities Collaboratives program, which is an effort of the Bureau of Primary Health Care to improve the quality of care in the nation’s community health centers and to reduce health disparities. This evaluation will involve 60 community health centers from throughout the country and nearly 10,000 patients with diabetes, asthma, or hypertension.

A more recent interest involves evaluating the effect of managed care on the quality of health care. Dr Guadagnoli recently reported that the delivery of appropriate care for acute myocardial infarction, as defined by established standards, varies for those Medicare beneficiaries enrolled in managed care versus those who receive care in the traditional fee-for-service setting. He is currently leading a study to determine which features of managed care are associated with the quality of care provided to patients with diabetes and hypertension and he is leading several studies that will examine the association between the level of managed care in a market and the quality of care for patients with acute myocardial infarction or cancer.

Dr. Guadagnoli is also interested in understanding how to improve the rate of organ donation in the United States. This work has focused on assessing the process of making a donation request in the hospital, but he has also studied the public’s and providers’ attitudes and beliefs about donation. He recently completed a study that estimated the organ donor potential in the United States and that evaluated the performance of the nation’s Organ Procurement Organizations.

Dr. Guadagnoli has served on review panels for the National Institutes of Health and the Agency for Healthcare Research and Quality (AHRQ). He is currently a member of AHRQ’s Health Services Research Dissemination and Implementation Review Committee and a member of the National Cancer Institute’s Expert Liaison Group of the Breast Cancer Surveillance Consortium . During 1994-1996 he was a Picker/Commonwealth Scholar studying various aspects of patient participation in decision making about medical treatment. Dr. Guadagnoli received his B.A. degree from Providence College and M.A. and Ph.D. degrees in experimental psychology from the University of Rhode Island.


HARVARD MEDICAL SCHOOL

Harvard Medical School has more than 5,000 full-time faculty working in eight academic departments based at the School’s Boston quadrangle or in one of 47 academic departments at 17 Harvard teaching hospitals and research institutes. Those Harvard hospitals and research institutions include Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Cambridge Hospital, Center for Blood Research, Children’s Hospital, Dana-Farber Cancer Institute, Harvard Pilgrim Health C are, Joslin Diabetes Center, Judge Baker Children’s Center, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Massachusetts Mental Health Center, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, VA Boston Healthcare System.

Additional Contacts:
John Lacey
Alison Harris
Judith Montminy
617-432-0442
public_affairs@hms.harvard.edu
Media Relations Page: http://www.hms.harvard.edu/news/media.html



John Lacey | EurekAlert!
Further information:
http://www.hms.harvard.edu
http://www.hms.harvard.edu/news/media.html

More articles from Health and Medicine:

nachricht Experiments in mice and human cells shed light on best way to deliver nanoparticle therapy for cancer
26.03.2020 | Johns Hopkins Medicine

nachricht Too much salt weakens the immune system
26.03.2020 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Junior scientists at the University of Rostock invent a funnel for light

Together with their colleagues from the University of Würzburg, physicists from the group of Professor Alexander Szameit at the University of Rostock have devised a “funnel” for photons. Their discovery was recently published in the renowned journal Science and holds great promise for novel ultra-sensitive detectors as well as innovative applications in telecommunications and information processing.

The quantum-optical properties of light and its interaction with matter has fascinated the Rostock professor Alexander Szameit since College.

Im Focus: Stem Cells and Nerves Interact in Tissue Regeneration and Cancer Progression

Researchers at the University of Zurich show that different stem cell populations are innervated in distinct ways. Innervation may therefore be crucial for proper tissue regeneration. They also demonstrate that cancer stem cells likewise establish contacts with nerves. Targeting tumour innervation could thus lead to new cancer therapies.

Stem cells can generate a variety of specific tissues and are increasingly used for clinical applications such as the replacement of bone or cartilage....

Im Focus: Artificial solid fog material creates pleasant laser light

An international research team led by Kiel University develops an extremely porous material made of "white graphene" for new laser light applications

With a porosity of 99.99 %, it consists practically only of air, making it one of the lightest materials in the world: Aerobornitride is the name of the...

Im Focus: Cross-technology communication in the Internet of Things significantly simplified

Researchers at Graz University of Technology have developed a framework by which wireless devices with different radio technologies will be able to communicate directly with each other.

Whether networked vehicles that warn of traffic jams in real time, household appliances that can be operated remotely, "wearables" that monitor physical...

Im Focus: Peppered with gold

Research team presents novel transmitter for terahertz waves

Terahertz waves are becoming ever more important in science and technology. They enable us to unravel the properties of future materials, test the quality of...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

“4th Hybrid Materials and Structures 2020” takes place over the internet

26.03.2020 | Event News

Most significant international Learning Analytics conference will take place – fully online

23.03.2020 | Event News

MOC2020: Fraunhofer IOF organises international micro-optics conference in Jena

03.03.2020 | Event News

 
Latest News

3D printer sensors could make breath tests for diabetes possible

27.03.2020 | Power and Electrical Engineering

TU Bergakademie Freiberg researches virus inhibitors from the sea

27.03.2020 | Life Sciences

The Venus flytrap effect: new study shows progress in immune proteins research

27.03.2020 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>